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General NPI Number Information
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NPI Number | 1588981054
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Entity Type | Organization
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Legal Business Name | BLANKENHEIM OCCUPATIONAL THERAPY
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Dates
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Enumeration Date | 04/23/2010
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 75 PANORAMA CREEK DR
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City | ROCHESTER
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State | NY
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Zip | 14625-2303
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Country | US
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Telephone | 920-830-6697
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 TRI PARK WAY STE A
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City | APPLETON
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State | WI
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Zip | 54914-1652
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Country | US
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Telephone | 920-830-6697
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Fax | 920-830-6707
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KATHY JANSEN
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Credential |
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Telephone | 920-830-6697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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